Morganstevens9348

PURPOSE To assess long-term cumulative treatment effects of intense pulsed light (IPL) therapy in meibomian gland dysfunction (MGD). METHODS Eighty-seven symptomatic participants (58 female, mean ± SD age, 53 ± 16 years) with clinical signs of MGD were enrolled in a prospective, double-masked, parallel-group, randomised, placebo-controlled trial. Participants were randomised to receive either four or five homogeneously sequenced light pulses or placebo treatment to both eyes, (E-Eye Intense Regulated Pulsed Light, E-Swin, France). Visual acuity, dry eye symptomology, tear film parameters, and ocular surface characteristics were assessed immediately before treatment on days 0, 15, 45, 75, and four weeks after treatment course completion on day 105. Inflammatory and goblet cell function marker expression, and eyelid swab microbiology cultures were evaluated at baseline and day 105. RESULTS Significant decreases in OSDI, SPEED, and SANDE symptomology scores, and meibomian gland capping, accompanied by increased tear film lipid layer thickness, and inhibited Corynebacterium macginleyi growth were observed in both treatment groups (all p  less then  0.05). Sustained clinical improvements occurred in both treatment groups from day 75, although significant changes from day 45, in lipid layer quality, meibomian gland capping, OSDI and SANDE symptomology, were limited to the five-flash group (all p  less then  0.05). CONCLUSIONS IPL therapy effected significant improvements in dry eye symptomology, tear film lipid layer thickness, and meibomian gland capping in MGD patients. Five-flash IPL treatment showed superior clinical efficacy to four-flash, and an initial course of at least four treatments is suggested to allow for establishment of sustained cumulative therapeutic benefits prior to evaluation of overall treatment efficacy. TRIAL REGISTRATION NUMBER ACTRN12616000667415. A well-functioning immune system is vital for a healthy body. Inadequate and excessive immune responses underlie diverse pathologies such as serious infections, metastatic malignancies and auto-immune conditions. Therefore, understanding the effects of ambient pollutants on the immune system is vital to understanding how pollution causes disease, and how that pathology could be abrogated. The immune system itself consists of multiple types of immune cell that act together to generate (or fail to generate) immune responses and in this article we review evidence of how air pollutants can affect different immune cell types such as particle-clearing macrophages, inflammatory neutrophils, dendritic cells that orchestrate adaptive immune responses and lymphocytes that enact those responses. Common themes that emerge are of the capacity of air pollutants to stimulate pro-inflammatory immune responses across multiple classes of immune cell. Air pollution can enhance T helper lymphocyte type 2 (Th2) and T helper lymphe health effects of air pollution. Oxidative stress occurs when antioxidant defences, which are regulated by a complex network of genes, are insufficient to maintain the level of reactive oxygen species below a toxic threshold. Outdoor air pollution has long been known to adversely affect health and one prominent mechanism of action common to all pollutants is the induction of oxidative stress. An individual's susceptibility to the effects of air pollution partly depends on variation in their antioxidant genes. Thus, understanding antioxidant gene-pollution interactions has significant potential clinical and public health impacts, including the development of targeted and cost-effective preventive measures, such as setting appropriate standards which protect all members of the population. In this review, we aimed to summarize the latest epidemiological evidence on interactions between antioxidant genes and outdoor air pollution, in the context of respiratory and cardiovascular health. The evidence supporting the existence of interactions between antioxidant genes and outdoor air pollution is strongest for childhood asthma and wheeze, especially for interactions with GSTT1, GSTM1 and GSTP1, for lung function in both children and adults for several antioxidant genes (GSTT1, GSTM1, GSTP1, HMOX1, NQO1, and SOD2) and, to a more limited extent, for heart rate variability in adults for GSTM1 and HMOX1. Methodological challenges hampering a clear interpretation of these findings and understanding of true potential heterogeneity are discussed. BACKGROUND AND AIMS Although traditional transoral outlet reduction (TORe) involves argon plasma coagulation (APC) before endoscopic suturing, modified endoscopic submucosal dissection (ESD) has also been used. This study aims to evaluate the safety and efficacy of modified ESD-TORe in comparison with traditional APC-TORe. METHODS This was a retrospective study of prospectively collected data of patients who underwent modified ESD-TORe and APC-TORe for weight regain after Roux-en-Y gastric bypass (RYGB). Our outcomes were (1) technical success, adverse events as categorized by the ASGE lexicon, and percent total weight loss (TWL) at 6 and 12 months, and (2) patients who underwent ESD-TORe were matched 13 based on gastrojejunal anastomosis (GJA) and pouch sizes to those who underwent APC-TORe. Selleckchem Plinabulin TWLs were compared. A linear regression was performed to control for any confounders. RESULTS Nineteen RYGB patients underwent ESD-TORe. Technical success rate was 100%. There were no severe adverse events. At 6 and 12 months, patients experienced 13.4±6.6 % and 12.1±9.3% TWL, respectively (p less then 0.05 for both). Nineteen ESD-TORe patients were also matched to 57 APC-TORe patients based on GJA and pouch sizes. At 12 months, the ESD-TORe group experienced greater weight loss compared with the APC-TORe group (12.1±9.3% TWL versus 7.5±3.3 TWL (p=0.036)). On regression analysis, ESD remained a significant predictor of %TWL at 12 months after controlling for age, sex, BMI, weight regain and years from RYGB (β=5.99, p=0.02). CONCLUSION Combining endoscopic tissue dissection with suturing providers greater and more durable weight loss for patients with weight regain after RYGB. BACKGROUND AND AIMS The objective of this study was to examine expert opinion and agreement on the treatment of distinct GERD profiles, from a surgical and therapeutic endoscopy perspective. METHODS We used the RAND/University of California, Los Angeles Appropriateness Method over 6 months (July 2018 to January 2019) to assess the appropriateness of antireflux interventions among foregut surgeons and therapeutic gastroenterologists. Patients with primary atypical or extraesophageal symptoms were not considered. Patient scenarios were grouped according to their symptom response to PPI therapy. The primary outcome was appropriateness of an intervention. RESULTS Antireflux surgery with laparoscopic fundoplication (LF) and magnetic sphincter augmentation (MSA) were ranked as appropriate for all complete and partial PPI responder scenarios. Transoral incisionless fundoplication (TIF) was ranked as appropriate in complete and partial PPI responders without a hiatal hernia. Radiofrequency energy was not ranked as appropriate for complete or partial responders. There was lack of agreement between surgery and interventional gastroenterology groups on the appropriateness of LF and MSA for PPI nonresponders. Rankings for PPI nonresponders were similar when results from impedance-pH testing on PPI therapy were available, except that LF and MSA were not ranked as appropriate for PPI nonresponders if the impedance-pH study was negative. CONCLUSIONS This work highlights areas of agreement for invasive therapeutic approaches for GERD and provides impetus for further interdisciplinary collaboration and trials to compare and generate novel and effective treatment approaches and care pathways, including the role of impedance-pH testing in PPI nonresponders. A thermo-responsive hydrogel of Pluronic F-127, containing PLGA nanoparticles loaded with a platelet lysate for wound treatment, was prepared. A high rate of incorporation of the lysate (about 80%) in the nanoparticles was achieved by the double emulsion-solvent evaporation method. The nanoparticles were characterized by measuring their size (about 318 nm), polydispersity index (0.29) and Z potential (-17.6), as well as by infrared and calorimetric techniques, and determining their stability as a function of time. It was found through measures of transepidermal water loss that the hydrogel containing the nanoparticles was capable of providing a semi-occlusive environment, necessary for the recovery of a wound. The inclusion of lysate in nanoparticles and this in turn in the hydrogel allowed a gradual release, which would avoid contact of the total dose with the biological medium. Studies with fibroblasts and in vivo in mice showed that the hydrogel containing nanoparticles with platelet lysate promoted faster tissue regeneration than the lysate in its free form, so this system is presented as a good alternative for the treatment of wounds. Territoriality is an adaptive behavioral trait that is important for animal's fitness and there still remains much to learn about the proximate mechanisms underlying the development of territoriality. We speculate that the formation of a conditioned place preference (CPP), an increased time allocation to the environment where a rewarding experience occurred, contributes to territoriality. Testosterone (T) plays an important role in modulating territorial behaviors and T pulses can induce a CPP. We confirmed previous findings in California mice (Peromyscus californicus) that T pulses can induce a CPP in singly-housed, but not group-housed males. Housing singly may be similar enough to dispersal in nature to initiate similar hormonal and neuroanatomical changes needed for the development of territoriality. We further revealed that T pulses interact with the single housing experience and appear to enhance the motivation to be aggressive towards a stimulus male. On a neural level, being singly housed upregulated levels of androgen receptors in the preoptic area, which positively correlated with the strength of the CPP. We speculate that this change in androgen sensitivity in the preoptic area is characteristic of males that have dispersed, making them more sensitive to T pulses. Also, single housing increased markers of synaptic plasticity in the nucleus accumbens, ventral and dorsal hippocampus, neural changes that may be associated with dispersal, reproduction and territory establishment. These behavioral and neural changes may reflect the life history transition from residing in the natal territory to dispersing and establishing a new territory. Hormones and Behavior was founded in 1969 by Frank A. Beach and members of his laboratory. Prior to the founding there was no journal specifically devoted to hormones and behavior. This paper explores how the editorship of the journal has developed over the first 50 years, going from the initial three male editors to the current female editor-in-chief, five associate editors (four men and one women), and a 98 member editorial board consisting of 46 men and 52 women. Early concerns that a specialty journal of hormones and behavior might ghettoize the field did not come to pass and the visibility and impact of the journal has helped to expand the spread of the field, now called Behavioral Neuroendocrinology. This growth accelerated with the creation of the Society for Behavioral Neuroendocrinology in 1996 and the adoption of Hormones and Behavior as the Society's official journal. The growth has been striking with total annual citations going from 1321 per year in 1997 to the current 10,874 annual citations. The journal's impact factor (JIF), 1.